Level of tumor necrosis factor production by stimulated blood mononuclear cells can be used to predict response of patients with inflammatory bowel diseases to infliximab

Clinical Gastroenterology and HepatologyJessen B, Rodriguez-Sillke Y, Sonnenberg E, et al. | June 04, 2020

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This study was sought to assess if production of tumor necrosis factor (TNF) by peripheral blood mononuclear cells (PBMCs) can be applied as a marker to predict response. Researchers performed a prospective study of 41 adults with inflammatory bowel disease (IBD) (mean age, 38 years; 21 male; 21 with Crohn’s disease and 20 with ulcerative colitis) not treated with a biologic agent within the past 6 months; patients were given their first infusion of infliximab at a hospital or clinic in Berlin, Germany. They obtained data on clinical scores, levels of C-reactive protein, and ultrasound results (Limberg scores) at baseline (before the first infusion) and after 6 weeks (3rd infliximab infusion). Production of cytokines (TNF, interleukin 1 [IL1], IL6, IL8, IL10, IL12p70, and IL22) were assessed by ELISA and performed cytometric bead array and flow cytometry analyses. This study's findings demonstrate that production of a high level of TNF by PBMCs (specifically CD14+ cells) from patients with IBD can distinguish those most likely to have a clinical response to infliximab therapy. A cutoff value of 500 pg/ml TNF distinguished responders with 100% sensitivity and 82% specificity in patients with Crohn’s disease.

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